Setting and Monitoring Treatment Goals and Discharge Criteria

Inpatient treatment’s primary goals include achieving safety, reduction in symptoms, preparing for a safe transition back to the community, and ensuring ongoing mental health treatment following discharge. Identifying and working towards specific treatment goals can facilitate symptom reduction, communication, and stabilization in the inpatient psychiatric hospital. This chapter reviews pertinent literature and key concepts related to goal setting and therapeutic alliance in this setting, illustrated with a case example. Other important elements of preparation for discharge are also discussed; these include psychoeducation, creating a safety plan, lethal means restriction counseling, and disposition planning. Defining discharge criteria seems straightforward in principle yet can be highly complex in real-world clinical circumstances; this chapter illustrates concepts to consider when weighing risks and benefits of further hospitalization or discharge. Since the post-discharge time period comes with an elevated risk of suicide, clinicians are obligated to partner with patients and families to anticipate and mitigate post-hospital risks.